H

| NW 88326

ee

| Assassination Records Review Board
Final Determination Notification

AGENCY : HSCA
RECORD NUMBER : 180-10068-10308
RECORD SERIES : STAFF PAYROLL RECORDS
AGENCY FILE NUMBER :

December 8, 1995
Status of Document: Postponed in Part

Number of releases of previously postponed information: 11 .
Reason for Board Action: The Review Board's decision was premised on several factors
including: (a) the significant historical interest in the document in question; (b) the
absence of evidence that the release of the information would cause harm to the United
States or to any individual.

Number of Postponements: 10

Postponements: All the postponements in this document represent Social Security numbers.

Reason for Board Action: The text is redacted because the public disclosure of the redaction could
reasonably be expected to constitute an unwarranted invasion of personal privacy, and that invasion of
privacy would be so substantial that it outweighs the public interest.

Substitute Language: SSN

Date of Next Review: 2017

Board Review Completed: 10/24/95

| Decld:32243274 Page 1

| | |

| . mtn oO Date:08/20/93
| Page:1

| JFK ASSASSINATION SYSTEM _

| | IDENTIFICATION FORM

AGENCY INFORMATION

AGENCY : HSCA
RECORD NUMBER : 180-10068-10308

RECORDS SERIES :
STAFF PAYROLL RECORDS

AGENCY FILE NUMBER :

| DOCUMENT INFORMATION

ORIGINATOR :
FROM :
TO :

HSCA

TITLE :

DATE : 01/01/77
PAGES : 13

SUBJECTS :
HSCA, ADMINISTRATION
BERNING, ELIZABETH L.

DOCUMENT TYPE PRINTED FORM

CLASSIFICATION : U
RESTRICTIONS : 3
CURRENT STATUS : P

DATE OF LAST REVIEW : 07/07/93

OPENING CRITERIA

COMMENTS

Box. #:1.

| ‘NW 88326
| Docid:32243274 Page 2

| 1

Office-of Finance use only:

mT — °
| NW 88326 Ce —
| Docld:32243274 Page 3 : cos

PAYROLL AUTHORIZATION FORM - -

‘

(Please Use Typewriter: ©. U.S. HOUSE . 5 REPRESENTATIVES.) (Any erasures, corrections, or changes

or Ballpoint Pen) authorizing official.)

To the Clerk of the House of Representatives:

| hereby authorize the following payroll action:

Employee Name (First-Middle-Last) .

Effective Date

Employee Social Security Number Type of Action

O Appointment

579=46-4548 SE] Satary Adjustment
(I Title Change |
- 0 Termination (At close of business on effective date)
4asaszinetions O Leave without pay (Beginning with effective date above and ending

close of business__-__-. -._--§ > }
Specify Date

(If type of action is an Appointment, Salary Adjustment, or Title Change, complete appropriate information below.)

Position Title Gross Annual Salary*

$24,900.00

* If emoloyee is a civil service annuitant (includes U.S. House of Representatives), the gross annual salary shown should include the annuity received by the employee

plus the salary received from the employing office.

(If Committee Employee, complete appropriate item below.)

1. O Standing Committee: Staff—O Clerical or 0 Professional.

3. 0 Joint Committee.

(If Employee of an Officer of the House, complete item below.)

Position Number If applicable, Level_

| certify that this authorization is not in violation of 5 U.S.C. 3110(b), prohibiting the employment of
relatives.

: (Signature of Authorizing Official)
LOUIS STORES

{Type or print name of Authorizing Official)
CHAIRMAN

All appointments and salary adjustments for employees under the House Classification Act and for Committee em- -
ployees, except those of the Committee on Appropriations, the Committee on the. Budget, and the Joint Committees, must
be approved by the Committee on House Administration. :

APPROVED:

, Chairman, Committee on House Administration -

| Office Code

Washingten D.C..20515 on this form must be initialed by the .

Elisabeth L. Berniag 1/4/79 .

aS I a OT eS SRT RPSL SEES EOE ON SO

oe alee

saeadactianes 2a beet at Adee eat

4

SR RDOTS Sn oT Oven PEL SOUAEOT DOV STEY TO COR ONC RAEELE POW ELT, Ot NORCO OT

IRF SOR RRT 2 00'S SCOR TET SIT CE RSE WN CO SE EOE


PAYROLL AUTHORIZATION FO°M re | :
(Please Use Typewriter \_“ U.S. HOUSE OF REPRESENTATIVES.’ (Any erasures, corrections, or changes .

or Ballpoint Pen) ©: ————Ss«SWWaashington, D.C. 20515 Snosage) initiated by the

To the Clerk of the House of Representatives:

| hereby authorize the following payroll action:

Employee ene (First-Middle-Last) = Effective Date Jo

O Appointment

C. Salary Adjustment

O Title Change

0 Termination (At close of business on effective date)

CO Leave without pay (Beginning with effective date above and ending

close of business

* If employee is a civil. service annuitant {includes U.S. House of Representatives), the gross annual salary shown should include the annuity received by the employee ,
‘plus the salary received from the employing office. |
(If Committee Employee, complete appropriate item below.) :
1. C1 Standing Committee: Staff—O) Clerical or 0 Professional. a.
Ga8 ah eis 4
2.0 Special (Investigative staff of Standing Committee) or Select Committee: Authority—H. Res.~_- __ of "Congress. ”
3. O Joint Committee. .
(If Employee of an’ Officer of the House, complete item below.) 4
Position Number___.__ If applicable, Level. Step___ 7
2
| certify that this. authorization is not in violation of. 4 U.S: Cc. 31 10(b),: prohibiting the employment of = =
relatives. at 4
December 11 78 a ‘
Dote___-_ ee , Wee 4
- TOES. on
tie appropriate, ‘signature of Subcommittee Chairman or Ranking Minority Member)" ====SSSSSType or print ew ahoing Oficial) 4
- Chai Sian a
"Type or print name ond tile of above official) == ee Title= If Member, Districtand Site). SSsSsS~CS 4
a+ --- +--+ a ee ee ee ee ee ee ee ne ee ee ee ne ne ne ee _ 3
_All appointments and salary adjustments for employees under. the House Classification Act and for Committee em-. a
_ployees, except. those ‘of the Committee on Appropriations, the Committee on the Budget, and the Joint Committees; must ‘3
be approved by the Committee on House Administration. 4
APPROVED:.___..- —- 4
Chairman, Committee on House Administration ,
— - A
Office of Finance use only: {
. : 4
Office Code a
(Revised: August 1, 1977) , i
Copy for Initiating Office or Committee a . 4

Docld:32243274 Page 4 : a ;

PAYROLL AUTHORIZATION. FORM. | o . Oo
| (Please Use Typewriter: * - U.S. HOUSE OF REPRESENTATIVES °  ‘(Any-erasures, corrections, or changes

or Ballpoint Pen) ~* Washington, D.C. 20515 on this form must ve Initiated by: the. -

To the Clerk of the House of Representatives:

| hereby outhorize the following payroll action: *

a Employee Name (First-Middle-Last) : ___Effective Date

AL. fevwing Becemar qs OFF
— Social Security Number . Type of Action _

C) Appointment
JE) Salary Adjustment
C1 Title Change
C1 Termination (At close of business on effective date)
— ASS ISS ha SOs , CO Leave without pay (Beginning with effective date above and ending

close of business

* dF employee | is-a civil service annuitant (includes U.S. House of Representatives), the gross annual salary shown should include the annuity receivéd by the employee
plus the salary received from the employing office.

(If Committee Employee, complete appropriate item below.)
- 1. oO Standing Committee: Staff—O) Clerical or O Professional.:::

2. 42) Special (Investigative staff of Standing Committee) or Select Committee: Authority—H. ReseSo off 38 tA Congress.
3. LO Joint Committee.

(If Employee of an Officer of the House, complete item below.)

; Position Number If applicable, Level

| certify that this authorization: is not in violation of :5 USE. 3110(b), prohibiting the employment of
relatives. we :

{Type or print name of Authorizing Official

a * Chairs VHaN

=

(Type or print name and title of above official) a ; Title= tf Member, District and Siate) -

_ All appointments and salary adjustments for employees under the House Classification Act and for Committee em-

be approved by-the Committee on House Administration.

APPROVED:

ed Chairman, Committee on House Administration

Office of Finance use only:
Office Code.

| NW 88326 | Fo
1d:32243274 Page 5 :

ployees, except those of the Committee on Appropriations, the ‘Committee on the: Budget, and the Joint Committees, must ---

wl cht a LA a

P00 aaa via eet UO bi

A tet kee

a
ad
La
.t
d
ox
“4
“4


~ PAYROLL AUTHORIZATION FORM ©

(Please Use Typewriter. *- OU. Ss. ‘HOUSE OF. REPRESENTATIVES. - ’ (Any erasures, corrections, or changes

: y. - on this form must he. initialed by the .
or Ballpoint Pen) ’ Washington, D.C. 20515 : authorizing official.)

To the Clerk of the House of Representatives:

| hereby authorize the following payroll action: -

Employee Name (First-Middie-Last) = ~=S| tt a Effective Date

Elizabeth L. Berning
Employee Social Security Number -

579-45-4548

Employing Office or Committee

ca of Action -

LJ Appointment

KkSolary Adjustment on

L_] Termination (At close of business on effective date)

Assassinations

(If type of action is an Appointment or Salary Adjustment, complete the following information.) -

Position Title Gross Annual Salary | -

— Chief Clerk $22,000

(If Committee Employee, complete appropriate item below.)

1. [_] Standing Committee: Staff—[_] Clerical or [_]-Professional.

2. [4 Special or Select. Committee: Authority—H. Res.: 465 of 25H Congress.

3. [_] Joint Committee.

(If Employee of an Officer of the House, complete item below.)

Position Number If applicable, Level_ Step.

| certify that -this. authorization is not .in violation of. > USC. 3170(6), “Prohibiting ‘the employment: of
relatives. =. at

(Type or print name of Authorizing Official)

cha tran

abd c . : uo (Title—If Member, District and Stote)

All appointments and salary: adjustments -for employees .uwnder the House: Classification Act and’ for- Committee: em-
‘ployees, except those. of the Committee.on Appropriations; the Committee on. the Budget, -and the-Joint’ Committees, must 078:
be approved by the Committee on House Administration. :- re . °

_ APPROVED:.______ pope eee n nee ----H- _.

Chairman, Committee on-House Administration -

‘Office of Finance use only:

Office Code

MSD at aia te ole eels aia stall bend! iliac Reuatialail aa Seah ay wb bas i cleo a: tb aah heute Hawa tab unetal ptuclned celdes Coat alae R28 Saath tas at Data Seacoast ha, ceva usb ecaitit esa «tite cits ne ate dec anges ah Wade! bcuseae. at eats!

. Copy for Initiating Office or Committee...

|
|
|

NW 88326 ee poe
1d:32243274 Page 6 : os ;

I
| NW 88326
| Decid:322432774 Page 7

MEMORANDUM

TO: Thomas Howarth
‘FROM: G. Robert. Blakey, Chief Counsel and Director Ves
RE:

Elizabeth Berning

lo- 0?

This is to advise that effective October 1, 1977,

Elizabeth Berning will become Chief Clerk at an annual salary
of $22,000.


PAYROLL: AUTHORIZATION FORM ; ~

> (Please Use Typewriter: ~ US. HOUSE ¢ OF REPRESENTATIVES - ". (Any erasures, corrections, or changes os

—_ aT 7 ; on this form must be initialed by the
or Ballpoint Pen) —- Washington, D:C. 20515 © authorizing official.)

soo cuttin! oe!
nas Waa ae ws SRN tec dace ae

To the Clerk of the House of Representatives: .

| hereby authorize the following payroll action: -

~__ Employee Name (First-Middle-Last) as —— = : ca “Effective Date

PA ee aed

Elizabeth L. Berning afl | : :
ae ‘Employee Social Security Number | Spee Type of Action ~ 7 e *
$79 46-4548 C1 Appointment . |
“Employing Office or Committee | CilSalory Adjustment > : a A |
‘Assassinations Cl Termination (At close of business on effective date} ;
(If type of action is an Appointment or Salary Adjustment, complete the following information.) :

Position Title | 7 7 | — | | | Gross Annual Salary ) | .

secretary .

(If Committee Employee, complete appropriate-item below.) . ~~

wanes cd ada edo os

chaeceleattic TRE Bie +

Lo Standing Committee: Staff—[_] Clerical or {_] Professional.

2. [Al Special or Select Committee: Authority —H. Res... 465 of Sth - Congress.

3. [] Joint Committee.

SEROUS TSPENE SS ENS ORTON STS

| (If Employee of an Officer of the House, complete item below.) ae ., Oe te ah

Position Number _..-----___.|f applicable, Level_

~f certify: that..this, authorization is’ not. in violation .of <5: USC. 3110(b), ‘prohibiting. the employment..of «~~
relatives. oe wt

Date. August 2 (41927

(ignature of Authorizing ‘Official)

é touts STOKES _

(Type or print name of Authorizing Official).

 CHATRMAR

(Title -If Member, District ond State) :

nek at Le le hehe be eaten SEtn delice pide le eae ot ted hae

 All-appointments and ‘salary.adjustments-for‘employees. underthe.House ‘Classification: Act and:-for Gommittee: ‘ems
vployees, except. those: of the-Committee.-on Appropriations, # the ‘Conimitteé: on’ the Budget, ‘and the Joint Committees, 1 must”
- be approved by the Committee on House. Administration. a

a An ae veal ay habe Pid ee al,

| proven:

soe “Chairman, Committee on n House Administration re er: |

ft

Ue IR Sa ALY ED wet SO NTGE SS SCT a OO ACRE TCL SH DORE OS re Sa ee

Office of Finance use only: |

Office Code

coe ° Copy. for initiating Office or Committee
lw 88326 oe 7 ;

PAYROLL. AUTHORIZATION FORM —

: (Pléase Use Typewriter. ~ -

“or Ballpoint Pen)

579 46 4548

. Assassinations

Elizabe th i. berning
- Employee Social Security Number

‘Employing Office or Committee —

ou. $. -HOUSE OF REPRESENTATIVES. . - (Any erasures, corrections, or changes.

Washington, D.C. 20515 - on this form must be initialed by the. _

To the Clerk of the House of Representatives: -

! | hereby authorize the following payroll action:

_Employee Name. (First-Middle-Last)

2. Special or Select Committee: Authority—H- Res:__

Position Title

3, [1] Joint Committee. -

(If Committee Employee, complete appropriate item below.)

authorizing official.)

Effective Date.

., Type of Action =

im Appointment
ot Salary Adjustment - _

[] Termination (At close of business 0 on effective date)

(If type of action is an Appointment or Salary Adjustment, complete the following information.) -

Gross Annual Salary

$16,000

1. [ Standing Committee: Staff—[_] Clerical or {J Professional

(If Employee of an Officer of the House, complete item below.) 08 eee

Position Number

relatives.

Office Code

| NW 88326
| Docld:32243274 Page 9

Office of Finance use only: «: --

SO eer nm rer errr res

_ APPROVED:..

- |. certify - that. this authorization. is not in violation of 5 USC, “311 0(b);- prohibiting. the-employment ‘of — ~:

» All_appointments. and: salary adjustments:for. employees. under : the: House: Classification -Act-and.-for Committee..emeri 2" 0s.
«ployee -except those. ofs.the: Committee -on.Appropriations;the Committee:on:the Budget, and:-the. Joint. Committees;- must: :
- be approved by the .Committee.on:House. Administration. Pea ea ed GEL Te : : 7

“Chairman, Committee. on House. Administration.

Wht ae he Sls Leta ete he ie Meee Peay Te CaS ate nat eR nN tae aaah SPD Cc Rb aaee wtetnen PL 6. endian oe ea teed ae eed eed tated atin Da la abate nc hana See Galatea el EN ed alla ate table 2 teat cae cate heater ttl cent had das

. : : y
CAA iat an bahia ada Ba ih al ant Ria ah itt nati

i

Docld:32243274 Page 10 : a |

PAYROLL AUTHORIZATION FORM

(Please Use Typewriter’ U. S. HOUSE OF REPRESENTATIVES - > (Any erasures; corrections, or changes. -. ~~

nat ; er on this form must be initialed by the
or Ballpoint Pen) “Washington, D.C: 20515- authorizing official.)

To the Clerk of the House of Representatives: -
| hereby authorize the following payroll action: °
Employee Name (First-Middle-Last) es a ~ 7 —_ Effective Date —

“Elizabeth iL. Berning oo apa?

“Employee Social Security Number = :
t
573 46 4548 C] Appointment

Employing Office or Committee [itSclary Adjustment.

(_] Termination (At close of business on effective date)

Assassinations

(If type of action is an Appointment or Salary Adjustment, complete the following information.)

Position Title : Gross Annual Salary |

$33,500

(If Committee Employee, complete appropriate item below.)

1. {_] Standing Committee: Staff—[_] Clerical or [ ] Professional.
2. [Special or Select Committee: Authority—H. Res. 465 ___of SSER Congress.

3. [-] Joint Committee.

(If Employee-of an‘Officer of the-House,-complete item below.) -

Position Number a If applicable, Level

— Vo certify that this authorization is -not. in. violation. of 5 USC.
relatives. Set

(Signature of Authorizing Official) —
Muis Stokes an
a (Type or print name of Authorizing Official)
ao Shatrman _

(Tile If Member, District and State}

All appointments: and salary adjustments for:employees under the House Classification Act and. for Committee em-"
-sployees, except. those: of the Committee on°*Appropriations, the Committee on the Budget, sand : the: ‘Joint: Committees, must |

be approved by the: Committee on House Administration. °

APPROVED:

- Chairman, Committee on House ‘Administration .

Office of Finance use only: .

Office Code.
4
- Copy for Initiating Office or Committee: oo... .- od
ae ee oa me we a aa
NW 88326 Foe

[Type of Action =—S Cd — | : Type of Action _ _ -

ERNEST PRN CT NO SURE BASE RTES RL ROE ORES OE OOS EN MRE TNO ODES Sa STERN

paihbvwddindis Fits inne shtaciatitiadd eC dates dence ties taantat cae detioe § Nvbn

saaaiate Leststice tn, is Anetta alg tat Ea tac

CORRS NARI AY SAILORS TCE ESO ON EST

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a a we gh
teh aba tik i ie ee ak hte Pac a tee

si Haas


| Docld:32243274 Page 11

- PAYROLL- AUTHORIZATION FORM ee ~ re ek

(Please Use. Typewriter’. UU. S: HOUSE OF. REPRESENTATIVES. . (Any erasures, corrections, or: -changes- ioe

‘or Ballpoint Pen) Washington, D.C. 20515 aa be initialed by the
To the Clerk of the House of Representatives: . °< --2220 thn
| hereby authorize the following payroll.action: = ©. +
Employee Name: .(First- Middle- -Last)- nae aa hk “ ae = Eifective Date on
Elizabeth L. Berning 21-77

“Type of Action <-.

- Employee Social Security Number .
579- 46-4548 (J Appointment
Employing Office or Committee’. = i A (A Salary Adjustment

Select Committee on Assassinations oO Termination (At close of business on effective dote)

(If type of action is an Appointment or Salary Adjustment, complete the following information.) - -
{- . Position Title

(If Committee Employee; complete appropriate item below.)

Gross Annual Salary

$10,900.

1. [-] Standing Committee: Staff—[-] Clerical or [=] Professional.

2: rt Special or Select Committee: Authority=H. Res wa. of 99. congress.
3. [| Joint Committee.

(If Employee of an Officer-of the House, complete. item. below.) -
Position Number__.. > _If applicable, Levels: 0 Step.2

oA certify that this. authorization..is :not in. violation. -:of .-5--U.S.G::-3110(b),.. prohibiting the -employment of

relatives,

: (Signature of Authorizing Official) ©
‘Reary B. Gonzalez

(Type or print name of Authorizing Official)

_ Chairman

. All-appointments-and :salary-adjustments: for.employees. under :the..House: Classification ‘Act..and.for-Gommittee: em- »

“ ployees; -except those..of the-Committee. on; Appropriations. the. ‘Committee on: the: e: Budget): :and:the Joint.Committees,- must ©. 2%

- be approved by the:Committee on: House. Administration.::

: Chairmen, Committee on House-Administration -

ee Oo APPROVED:

. Office of Finance-use only: - °.-

Office Code

‘Copy for Initiating Office or Committee —

SERS ee ee se stn

Pe

| NW 88326 =. ne - _.

. a . + . are . . . _ . . : :
‘ * . ’ . 4 y a * . ° a
. an ‘ . . an . vod - a ! - +
Salata DNA tdi ta sd i os tsa altel acini staan sabato cats waitin rata obec fie aR aaah ae ata ede aad At ea aad era hed ee AA alsa cE EM Ey martes taeda art canna Rod an east aad See Ae ti AAE Sa at Reha ihe bie bhi Sk Sika Tai inc Toc counts at Bee ane ari augue antenatal inte

~ PAYROLL AUTHORIZATION FORM. . .
we (Please Use Typewriter o f Ue S: HOUSE OF: REPRESENTATIVES (Any erasures, corrections, or changes

Se

. - “an this form must be initialed: by. the
or Ballpoint Pen) ; t ‘Washington, D.C. 20515 | authorizing official )

To the Clerk of the House of Representatives:

| hereby authorize the following payroll action: | >
; Employee Name (First: Middle-Last) . 7 Effective Date
| (digebeta L. Ser atin 3 - VESf27 7
i. Employee Social Security Number Type of Action

’ ’ an wv
Ce .

U Appointment

© Salary Adjustment :

LC] Termination (At close of business on effective date)

- | sébict Commi ites on fssagsina tions

_(If type of action is an Appointment or Salary Adjustment, complete the following information.) |

Position Title Co - Gross Annual Salary :

(If Committee Employee, complete appropriate item below.)

1 Standing Committee: Staff—[_] Clerical or [“] Professional.

Ares
-s  .2. fe] Special « or Select Committee: Authority— -H. Res.__* ' of 225 Congress.
“3. [_] Joint Committee.

(If Employee of .an Officer of the House, complete item below.)

\,

Position Number -__.If applicable, Level

_------___-__.|f applicable, Level___- Step___
- - " 5

| certify that this authorization is notin violation of .5 U.S.C. - 3110(b),.. prohibiting the employment of -

relatives. , .
\ a) ‘
Date... oo a ae a,
(Signature of Authorizing Official)
Henyy OG, Songelor

(Type or print name of Authorizing Official)
re ;
Cd) mar
_ (Title ~If Member, District ond State) rr ~

All -appointments and salary.adjustments for employees -under the“House. Classification. Act and. for Committee em-

[= s- ployees, except those of the Committee on Appropriations; the: Committee on-the Budgetz-and:. the Joint Committees, “must”
be approved by the Committee on House Administration.

- APPROVED: — a

‘Office of Firiance use only: ;
Office Code™

ate cnn een alten Ke ol desea Set an nena eee be deme

rT : oe oo 7
| NW 88326 FO —
| Docid:32243274 Page 12 : vo ;

W 88326
ochd:34243274 Page 13

hat Na i aa TT a int Da ll hE ik i aaa aaah ere at aaa etree eas ae aaa aa aaaaaaaa maaan

TO WHOM IT MAY CONCERN

Please consider this verification that
Elizabeth L. Berning began employment, permanent
full-time status, with the House of Representatives

Select Committee on Assassinations January 1, 1977.

LEA Colo hb Ppa fe

Rebecea Wheeler Martin
 . Chief Clerk |

January 31, 1977


"PAYROLL AUTHORIZATION FORM” Ho, ae ;

_ ; , employee’ Social Security Number | Type of Action ! :

¥L_] Appointment

Employing Office or Committee o Salary Adjustment,

Setcct Comittee on Assassina Lisas

mn Termination (At close of business o on ‘effective date) ;

». (IF type of action is an Appointment:or Salary Adjustment; complete the following information.)

“Position Title —

(If Committee Employee, complete appropriate item below.)

1. [_] Standing Committee: Staff-[] Clerical or [-] Professional. .

\

6

2.8] a Special or Select Committee: Authority= H: Res. TB off&tA Congress.
p ¥- g

» 3, 4 Joint Committee,

aes =

~. (If Employee of an Officer of the House, complete item below.)

Position Number_____ oe If applicable, Level_

Step__.

t ~~

relatives.
Jecomber 5
Date.______ LL EGER oe 192 _ anne 8 one.
, nv ; (Signature of Authorizing Official)
. Ca aye
a Thomas hb. Jewry 138) jn Gi A ti BT aed Co
. ~ (Type or print nome of Authorizing Official)
~ pelagh Counittee of Aesdaiinalinss -
- ; ~ . (Title-1f Member, District and State)
Mew we oe 5

~AlL. ‘appointments and-salary.adjustments. for. employees under the. House Classification Act and:for Committee: em-.-

cployees, except: those: of the:-Committee on Appropriations, the:Committee -on: the Budget, and-the Joint ‘Committees, must .- *

be approved by the-Committee on House Administration..

na

Be APPROVED: vo _

Office of Finance use only:

Office Code

.lecertify that. this.-authorization is not in violation of 5 US.C. 3110(b), prohibiting: the employment of :

"2. «(Please Use Typewriter . KU. S. “HOUSE: OF REPRESENTATIVES — - (Any erasures, corrections, or changes =; «
“ we we a this form must be initialed by the
oo “or Ballpoint Pen) eee 2. / Washington, D.6..20515 . hs authorizing official.) .
To the Clerk ofthe House of Representatives; = 89 Se
| hereby authorize the following payroll action: oS os 7
— SS —
Employee Name (First-Middle-Last) . - Effective Date

| Docid:32243274 Page 14 : vs


po MEMORANDUM

70: All Staff Employees —
FROM: Budget Officer _
. DATE: January 3, 1977

RE: Payroll certification

‘to the House Finance Office requires, among other things, the |
relationship, if any, of each. staff employee to any current —
_ Member of Congress (those taking office January 3, 1977).

. The following are the relationships to be included in
the certification: a Co

father cee nephew Re brother-in-law _
mother  ==——s—i“‘ ai; ce UCUCC~——C—i‘ Cs Sistter-in-le
som. - o--. husband | oo stepfather

. daughter si t~—‘i‘istsSCSSCW fe et  - stepmothex.
“* | brother ° sti<tsté‘i‘ eS Cefather-inrlawe ‘stepbrother
sister 7 . ~. mother-in-law. -. stepsister -
‘uncle son-in-law ~ half-brother .
punt _ daughterinlaw half-sister

first cousin . Dt . a

All staff employees are requested to complete this
“form and return it to the Budget officer. |

- Approved - a a
_.Richard A. Sprague

SE ee am a ee ee ee ee ee ee we ee re me we ee ne eT eT eee

ey am. not related ae

| i aL am related by the following relationship

rgnature of Employee

| Docld:32243274 Page 15 :

Cn ;

Starting with the January, 1977 payroll, the certification |

wet Nw

